By Quentin McDermott for Four CornersUpdated May 14, 2012 17:52:08
One of Australia's most respected neurosurgeons says children and adolescents who are concussed three times playing football should not play again.
Professor Jeffrey Rosenfeld's comments come on the back of mounting evidence of the long-term impact of ongoing head trauma on athletes.
Speaking on tonight's Four Corners, Professor Rosenfeld, the director of neurosurgery at the Alfred Hospital in Melbourne, says repetitive concussions can cause serious long-term damage.
"I personally would say three significant concussions, three strikes and you're out. I would be a bit wary of that player going back," he said.
"They can still play sport but perhaps not the rough and tumble and risk associated with the tackling in a contact sport like football."
Concussion in sport - and particularly in rugby league, rugby union and Australian rules - is now a hotly debated issue, with parents, players, coaches and administrators increasingly focused on the potential long-term brain injuries which may result from repeated head knocks.
And Professor Rosenfeld has found an unlikely ally in Australian rules great David Parkin.
"Jeffrey's one of the more astute, I think, and well-balanced in terms of what needs to be done," Parkin said.
"As a parent and as a grandparent that will stick in my gizzard from now on as I watch my grandchildren go through the same processes - because I think coming from him who has probably got as much knowledge as anybody else in this country about those issues - that seems to be pretty strong advice and something that we should maybe adhere to."
Parkin, a winner of two premierships with Hawthorn as player and coach and three premierships coaching Carlton, tells Four Corners that it was one final, monumental hit that ended his playing career.
"I coached and played in Western Australia in 1974 and was knocked out at the very first bounce in a game at Claremont at 2.00pm, or a few minutes after two, and woke up in Charlie Gairdner Hospital at 4.00pm the following day," he said.
"So I was out for 26 hours and that finally convinced me that it was time to stop playing and stop punishing myself."
Tonight's Four Corners features interviews with three former elite players from different codes, all of whom sustained multiple concussions while playing football at the highest level.
Former North Queensland Cowboys player Shaun Valentine says he suffers severe memory loss following a series of concussions playing rugby league.
Valentine is so worried about the effects of hits sustained during his career that he has pledged his brain to Boston University's School of Medicine for research after his death.
In the US, a series of high-profile athlete deaths was the catalyst for the formation of special unit at the university specialising in the effects of repeated head trauma.
Doctors have set up a brain bank to study the brains of former athletes who have died and discovered evidence of chronic traumatic encephalopathy (CTE) in the brains of former NFL players, some of them who died in their teens and early 20s.
CTE, a neurodegenerative disease, was first diagnosed in boxers in the early part of the 20th century.
With symptoms including memory loss, confusion, depression and eventually progressive dementia, it is a crippling disease that can rob people of their cognitive function in the prime of their life.
Worryingly, researchers at Boston University say they now believe CTE can be caused not just by repeated head knocks, which cause concussions, but also by repeated sub-concussive hits.
This research is controversial, and Professor Andrew Kaye, director of neurosurgery at the Royal Melbourne Hospital, says current studies do not show a definite link.
"There is no clear evidence that sub-concussive injuries cause permanent brain damage leading to disastrous sequelae, outcomes, but we have to have an open mind about it and I've got an open mind about it," he said.
Currently, it is only possible to diagnose CTE with any certainty after a patient has died.
But with the help of Australian scientists, ground-breaking research has started in Boston which may eventually allow doctors to diagnose CTE in living athletes.
In Boston, 100 former NFL footballers are undergoing tests using a technology known as magnetic resonance spectroscopy.
Chris Nowinski, a co-director of the Centre for the Study of Traumatic Encephalopathy at Boston University's School of Medicine, says the research will hopefully lead to a live diagnosis.
"What we hope to get out of studying living former NFL players is to understand a criteria through which we can diagnose this disease with confidence in living people," he said.
Australia has helped to develop the new technology which makes it possible for doctors to detect alterations in brain chemistry following a concussion.
Carolyn Mountford is a professor of radiology at Harvard Medical School and director of the new Centre for Magnetic Resonance in Health at the University of Newcastle.
Dr Mountford says the technology shows the impact of repetitive head trauma on the brain.
"I think we're at the stage now where we can say, 'Yes, repetitive hits to the head does cause a difference to brain chemistry'. Whether we can do anything about it remains to be determined," she said.
But despite Australia's role in developing the technology needed to study footballers' brains and detect alterations in their brain chemistry, Australian clubs and football codes have been slower than America to act.
Plans to start testing current and former rugby league players from the Newcastle Knights have been deferred, even though funding for a pilot study is available.
And plans to start testing AFL players in the same way at the Florey Neuroscience Institutes' Melbourne Brain Centre are also some way off.
The discoveries being made about CTE and repeated head traumas could have serious legal implications for Australia's football codes.
In America, more than 1,500 footballers have gone to court claiming that the NFL hid the dangers of concussion from them.
In Australia, several AFL players who have suffered the after-effects of repeated concussions have now sought and won compensation from their clubs.
AFL player agent Peter Jess has called for a brain bank to be established in Australia, saying the issue "has the potential to be a firestorm unless we take the appropriate action".
"We don't have a study in CTE. It is absolutely critical that we have that, and if we're serious about this we must create a brain bank across all codes," he said.
All the major football codes have implemented stricter guidelines for dealing with concussion, and the NRL is in the process of undertaking a survey into the long-term effects of concussion on the 400 former State of Origin players.
You can watch the full report on ABC1's Four Corners tonight at 8:30.
Tags: sport,
american-football,
australian-football-league,
rugby-league,
rugby-union,
neuroscience,
sports-injuries,
health,
australia,
united-states First posted May 14, 2012 14:36:44
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